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Firmagon Injection Site Pain

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Posted 2/9/2022 2:54 PM (GMT -5)
Hello All

Dad had his first shot of ADT yesterday at MSKCC Bergen. He got two shots of Firmagon in his stomach, he's been having pain at the injection site and when he sits down or lifts his leg. Is this normal and how long does it take for the pain to go away. We've been using cold compress to help ease the pain.

Thanks and grateful always
Posted 2/9/2022 4:20 PM (GMT -5)
Yes this is normal, especially for the first dose. The first dose is triple the amount of the following monthly doses and is administered as two shots in the abdomen. Mine were pretty painful the following day. It felt to me like after the first day of phys-ed when you had do do a bunch of sit-ups you weren't in shape for - hurts especially when getting up from bed or from a chair.

The good news is the pain diminishes over the next couple of days until it is gone. The regular monthly shots are much better. Still some pain - like a bee sting - that comes on a few hours after the shot and fades after a day or two. I noticed some of mine hurt less than others though not sure why, but all were way better than that first triple dose. There will be a small marble-sized lump under the skin that is painless but will be there for a month or so after each shot.

My first time on ADT I was on Firmagon for a year - the year was because I was randomized into the control arm of a trial. It brought my PSA down to undetectable in only a couple of months. After my last shot I went on break from treatment as was able to go almost two years before needed to start a new round. For the second round of ADT I had Lupron instead of Firmagon but only because it was just after the start of the first COVID wave and neither I nor my oncologist wanted the added risk of monthly visits for shots. Because I had virtually no side effects from the Firamgon I'd have stayed with it and the monthly shots instead of Lupron if it hadn't been for COVID. In my experience, at least, the minimal side effects made the monthly trips and minor pain for a day or two afterwards worth staying with Firmagon.

I hope your dad does as well with his treatments.
Jim
Posted 2/9/2022 6:03 PM (GMT -5)

Our loyal member Bohemond has given excellent insight in response to your question.

I want you to know - I also had the "bee sting" feeling at the injection site --- and a swollen lump that formed on my abdomen at the injection site.

Loose -fitting track pants and boxer shorts felt great -- after changing out of my Dockers dress pants and Oxford dress shirts that I wore to work each day.

I have been on continuous ADT injections since my diagnosis in 2013.

I started on LUPRON, but we discovered it wasn't fully suppressing my testosterone levels, which resulted in "spikes and flares" in PSA levels.

I tried FIRMAGON next --- with the same "spikes and flares" in testosterone and PSA.

There were also those pesky site injection reactions for me, every single month, I will say. The "bee sting" soreness & tenderness & swelling lasted a week for me, each time, unfortunately.

That was my experience with FIRMAGON.

In time, my oncologist suggested I try ZOLADEX injections.

I had a much better experience with ZOLADEX, and have remained on it for years. It has helped keep my testosterone and PSA in check.

Above all else --- for any fellow on ADT --- such as LUPRON, FIRMAGON, or ZOLADEX --- it's essential to have your doctor request an occasional testosterone test, to make sure your form of ADT is working to its highest potential.

In my case, it took three different forms of ADT to find the one that helped me the most.

Each case is different --- and there were no gaps for me, as we transitioned from one form of ADT to another.

ZOLADEX is not as commonly used as LUPRON or FIRMAGON, but for me, it worked the best.

It's important to know there are options! This was important for my case!

Here's hoping your father sees a nice drop in PSA values!

CYCLONE - # Iowa State University
Posted 2/9/2022 9:50 PM (GMT -5)
The first shot(s) of Firmagon are not fun. But it will get better in a few days. Hang in there…and then the monthly shot is only half as bad.
Posted 2/10/2022 12:19 AM (GMT -5)
Dkan, I had the first two shots of Firmagon before starting my radiation treatments. I had some pain at the injection site, but nothing serious. However, for the next two weeks I had two raised red lumps the size of silver dollars. The lumps itched like huge mosquito bites. I called about the itching and was told not to rub or itch the site. That slowly went away. My Uro wanted me to switch to Orgovyx which has shown to work just as well as Firmagon. It is just one pill a day. It can be expensive, but my URO worked with the insurance and my co-pay is $40.00 a month. Wishing you and your dad the best.
Jack
Posted 2/15/2022 9:09 AM (GMT -5)
Thank you for all your re-assurance and valuable input. As mentioned my father is back to normal after 3 days.

Regards
Posted 2/15/2022 11:40 AM (GMT -5)

Hello, DKan ----

Sending supportive thoughts to you & your dad!

Glad to hear the initial "honey 🐝 bee 🐝 sting" from the FIRMAGON shot has subsided in short order!

I know your dad's doctor will stay on track of those PSA levels, going forward.

Remember to have your dad request an occasional TESTOSTERONE test!

No matter which form of ADT a fellow is on --- LUPRON, FIRMAGON, or ZOLADEX, for example --- it's ESSENTIAL to make sure the ADT injections are suppressing that testosterone level --- to starve those hormone-dependent cancer cells of their fuel source.

Many doctors fail to do this --- it was a HUGE oversight on the part of my original oncologist.

My oncology team saw this --- and ultimately discovered a form of ADT that worked even better for my case!

When my oncologist stated emphatically that he refused to try anything else besides LUPRON - that's the day I told him that my oncologist would be the new quarterback on my medical team, going forward.

That was a day of new beginnings --- new doors opened in my treatment plan.

One thing I learned --- from my case --- I discovered it was easy to transition to other forms of ADT injections, as my situation merited.

These changes were based on "spikes and flares" in my testosterone levels, which created flares in my PSA levels.

In my case, ZOLADEX --- the third type of ADT that we tried --- worked much better! Third time is the CHARM, as they say! There's many stories - this one is mine.

One more thing --- every fellow here who is on ADT will attest to the importance of daily exercise.

It helps with potential weight gain & lagging energy.

I walk trails, each day --- and maintain high levels of energy. I walk on weekends, too.

My lesson learned? Encourage your dad to STAY ACTIVE!

My best to you and your dad!

Keeping in touch,
CYCLONE - # Iowa State University
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